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老年髋部骨折患者骨质疏松的识别与治疗。

Identification and treatment of osteoporosis among elderly patients with hip fractures.

机构信息

Geriatrics Service, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - São Paulo/SP, Brazil.

出版信息

Clinics (Sao Paulo). 2009;64(12):1201-4. doi: 10.1590/S1807-59322009001200010.

Abstract

OBJECTIVE

To evaluate the profile of osteoporosis treatment among patients hospitalized due to hip fractures at a tertiary-level university hospital. To compare the impact of hospitalization on approaches toward treating bone mass losses.

METHOD

The medical records of 123 hip fracture patients aged 60 years and over at the Institute of Orthopedics, Hospital das Clínicas, University of São Paulo School of Medicine, between 2004 and 2006 were reviewed and analyzed with respect to approaches towards investigating osteoporosis and treatments before and after fracture.

RESULTS

The patients' mean age was 78 +/- 8.3 years, and the majority were women (71.54%). The patients had a mean of 2.72 comorbidities and used 3.26 medications on average. Among these patients, 12.3% reported a previous diagnosis of osteoporosis, and 5.83% were on medication for this. The mean waiting time for surgery was 6.3 +/- 7.54 days, and seven patients (5.7%) died during the hospitalization. There were no investigations using bone densitometry, no changes in osteoporosis therapy between admission and discharge (p = 0.375), and no reports of referrals for the patient to have access to treatment.

CONCLUSIONS

Investigations and treatments of osteoporosis and strategies for preventing new fractures were not implemented during the hospitalization of these elderly patients with hip fractures, even though this is the most feared complication of osteoporosis. These data need to be disseminated so that professionals dealing with elderly patients are attentive to the need for primary and secondary prevention of osteoporosis because of the impact of fractures on these patients' quality of life, independence, morbidities, and mortality.

摘要

目的

评估在一家三级大学附属医院因髋部骨折住院的患者的骨质疏松症治疗概况。比较住院对治疗骨量流失方法的影响。

方法

对 2004 年至 2006 年期间在圣保罗大学医学院附属医院骨科研究所住院的 123 名 60 岁及以上髋部骨折患者的病历进行回顾性分析,主要分析了骨质疏松症的检查方法和骨折前后的治疗方法。

结果

患者的平均年龄为 78 +/- 8.3 岁,大多数为女性(71.54%)。患者平均有 2.72 种合并症,平均使用 3.26 种药物。其中,12.3%的患者报告有骨质疏松症的既往诊断,5.83%的患者正在服用治疗骨质疏松症的药物。手术平均等待时间为 6.3 +/- 7.54 天,7 名患者(5.7%)在住院期间死亡。没有使用骨密度仪进行检查,入院和出院时骨质疏松症治疗没有变化(p = 0.375),也没有报告为患者提供治疗的转诊。

结论

即使骨质疏松症最害怕的并发症是髋部骨折,这些老年髋部骨折患者在住院期间也没有进行骨质疏松症的检查和治疗,以及预防新骨折的策略。这些数据需要传播,以便处理老年患者的专业人员注意到骨质疏松症的一级和二级预防的必要性,因为骨折对这些患者的生活质量、独立性、合并症和死亡率有影响。

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